Video: Four differences between urban and medical practices

What are the biggest dissimilarities between being a doctor in big cities versus more rural areas? While all practicing doctors go to medical school, the types of practices they run afterwards can be very different. Alongside Dr. Rithesh Ram, a rural generalist, we decided to go through some big differences between urban and medical ones. TRANSCRIPT Dr. Ram speaking: It took one of my last rotations that was actually a rural rotation out in Drumheller. And I remember, before going out to drive, I remember my wife always saying, well, you never actually looked very satisfied in your job or when you're out to do any of your stuff in the city. And I remember distinctly when I came back from just four days of being in Drumheller, practicing and seeing what the field was like to be in a rural area. She said, basically, when I walked in the door, “you look so happy.” And I said, Well, was I not happy before? There was a distinct, huge difference. And that's where I said, rural medicine, it reminded me exactly why I wanted to be a physician, and why this is something that I love doing and wanted to continue to do. 1. Rural generalists will have more responsibilities in areas other than their specialties So the biggest difference probably is that the only similarity between rural medical practice and urban medical practice, the fact that we have the word medical there, to be honest with you, we have a full scope. And that's what's needed. That's what's expected. So what does that mean? That means our days don't end when our clinic hours end. And we have other roles and responsibilities in multiple different areas. So we also have to see patients in the hospital, whether it's in the emergency department, whether it's admitted patients and into the acute care, some rural areas will also have exempt community cancer centers where we also have to tie in and, and make time for. Most of us will also have patients that are part of any of the assisted facilities, like long term care, continuing care, plus the clinic that we also have. That’s the difference when we talk with our urban colleagues that's forgotten, or maybe it's just not known. And hopefully, by doing something like this, we provide some of that education. But it's expected that while you're in the clinic, there isn't anything else that you need to do with your day. Well, that's absolutely not true. 2. Rural generalists might not have access to the same resources as urban doctors Some other big differences between rural and urban practices are that we also don't have any of the facilities or investigatory capabilities that we would have in the city. So it's very common for us to, let's say, be on call in the emergency department and need to call a colleague to consult them about a particular patient. And I'll say more than half the time, they'll say things like “well, why don't you have your CT right now? Why can't the patient get a CT?” Well, we don't have one or that's just not possible at these hours, which is something that's forgotten and unheard of in the city. You have live CAT scan capability for all hours, technically, you can get an MRI in 24 hours, an ultrasound most of the day. That understanding or that lack of understanding is something that's a big difference between the two. 3. Rural generalists might have more expectations put on them Another deterrence that I don't feel should be is the fact that the expectations on you clinically, are also quite a bit bigger. So the expectation that your breadth and depth of what your medical and procedural knowledge would be is greater in rural and remote areas. And I see that again as more of a benefit but it can be a hindrance to some that just feel that it might be too much for them to take on: too much for them to always remember, too much for them to be responsible for. But then I think we get a lot of training through all of med school and residency etc. And I feel it's a benefit to be able to use all of that and not have that not have that loss. 4. Rural generalists might be more flexible and prepared in emergency situations The big difference I guess, probably a lot of my colleagues will talk about the times where you're sitting in an airplane and you get the call out for “Is there a doctor on the airplane?” Urban doctor will say obviously, what's going on and what do they need one for but I know that for myself as well as any of my rural colleagues, we're very capable to jump up go see what it is whether it's a mom that is pregnant that broke her water whether it's a person with chest pain, those are things that we handle in our in our week to week, month to month lives. So these things are fresh, we do it on a regular basis. Others don't necessarily have that same comfortability with those situations. They haven't needed to keep up with those skills or keep up with that knowledge.

Video: Four differences between urban and medical practices

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